scholarly journals Thyroid Cancer and Telemedicine during the COVID-19 Pandemic

2021 ◽  
Author(s):  
Sumedha V Chablani ◽  
Mona M Sabra
Keyword(s):  
Thyroid Cancer ◽  
Low Risk ◽  
American Thyroid Association ◽  
Limited Information ◽  
Long Term Follow Up ◽  
Future Care ◽  
Risk Patients ◽  
Virtual Platform

Abstract The COVID-19 pandemic has forced endocrinologists to utilize telemedicine to care for their patients. There is limited information on the experience of endocrinologists in managing patients with thyroid cancer virtually. We sent a nine-item questionnaire to endocrinologists and endocrine surgeons at our institution to better understand the barriers and benefits of caring for patients with thyroid cancer via telemedicine, as well as how we can incorporate telemedicine into our future care of patients with this malignancy. Of the nine physicians who responded, the majority of them listed technological issues with the virtual platform as a challenge in caring for patients with thyroid cancer remotely. Additional barriers included difficulty in expressing empathy, decreased ability to coordinate care with the interdisciplinary team, and lack of the physical exam. Benefits included compliance with social distancing measures and convenience for patients with American Thyroid Association (ATA) low-risk thyroid cancer who presented for follow-up visits. Overall, physicians were satisfied or strongly satisfied with caring for patients with thyroid cancer remotely, especially low-risk patients on long-term follow-up. That said, post-pandemic, they recommend that some patients be seen in-person, including symptomatic patients and ATA high-risk patients. While the COVID-19 pandemic has allowed endocrinologists to manage patients with thyroid cancer remotely, the providers have faced challenges, some of which can be improved upon. Further studies will help determine how telemedicine affects patient outcomes, including satisfaction, disease progression, and survival, which will better inform how we may incorporate this practice into our future care of patients with thyroid cancer.

Improved Survival with Ursodeoxycholic Acid Prophylaxis in Allogeneic Stem Cell Transplantation: Long-Term Follow-up of a Randomized Study of the Nordic Bone Marrow Transplantation Group

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 488-488
Author(s):  
Tapani Ruutu ◽  
Eeva Juvonen ◽  
Mats Remberger ◽  
Kari Remes ◽  
Liisa Volin ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Cumulative Incidence ◽  
Low Risk ◽  
Long Term Follow Up ◽  
Risk Patients

Abstract Abstract 488FN2 The role of ursodeoxycholic acid (UDCA) in the prevention of hepatic complications after allogeneic stem cell transplantation was studied in a prospective randomized open-label multicenter trial. A total of 242 patients were allocated to receive (n=123) or not to receive (n=119) UDCA at the dose of 12 mg/kg/day from the day preceding the conditioning until day 90 post-transplantation. The median age was 39, range 1–59 years. 231 patients had a malignant hematological disease. 140 patients had a low-risk disease (acute leukemia in CR1, CML in CP1, or non-malignant disorder), 102 high-risk disease (all other). Of the donors 132 were siblings, 2 other related and 108 unrelated. TBI-containing conditioning was given to 219 patients. 190 patients received a bone marrow graft and 52 a blood stem cell graft. As GvHD prophylaxis 235 patients were given cyclosporine and methotrexate with (n=112) or without (n=123) corticosteroid. There were no significant differences in patient characteristics between the study groups. The results were reported after 1-year follow-up (Blood 100: 1977–1983, 2002). In the group given UDCA prophylaxis the survival was significantly better, the incidence of acute GvHD was lower, there were fewer patients with high bilirubin and ALAT levels, the non-relapse mortality was lower, and there were fewer deaths in GvHD. We report here the long-term outcome. The median follow-up of living patients was 155 (range 37–184) months. Two patients were lost early (12–15 months) for follow-up. The survival difference seen at one year remained similar in the long-term follow-up. At 10 years, 48 % of the patients given UDCA and 38 % of the control patients survived (p=0.037). The survival difference was highly significant among the low-risk patients (63 % vs. 46 %, p=0.019) but there was no difference among the high risk patients (25 % vs. 29 %). In the total patient material, the cumulative incidence of non-relapse mortality was significantly lower among the patients given UDCA (28 % vs. 41 %, p=0.031). There was no significant difference in the cumulative incidence (58 % in the UDCA group vs. 68 % in the control group among patients at risk, p=0.47) or severity of chronic GvHD. In the long-term follow-up there were no significant differences in liver problems between the study groups. The cumulative incidence of relapse did not differ significantly between the arms. In the UDCA group 23 % and in the control group 20 % of the patients had a relapse; among low risk patients 14 % vs. 12 %, respectively. There were seven secondary cancers in both study arms. These long-term results continue to support the useful role of UDCA in the prevention of transplant-related complications in allogeneic stem cell transplantation. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Personalized management of differentiated thyroid cancer in real life – practical guidance from a multidisciplinary panel of experts

Endocrine ◽  
2020 ◽  
Vol 70 (2) ◽  
pp. 280-291
Author(s):  
Alfredo Campennì ◽  
Daniele Barbaro ◽  
Marco Guzzo ◽  
Francesca Capoccetti ◽  
Luca Giovanella
Keyword(s):  
Nuclear Medicine ◽  
Thyroid Cancer ◽  
Clinical Practice ◽  
Molecular Imaging ◽  
Routine Clinical Practice ◽  
Whole Body ◽  
Neck Ultrasound ◽  
Long Term Follow Up

Abstract Purpose The standard of care for differentiated thyroid carcinoma (DTC) includes surgery, risk-adapted postoperative radioiodine therapy (RaIT), individualized thyroid hormone therapy, and follow-up for detection of patients with persistent or recurrent disease. In 2019, the nine Martinique Principles for managing thyroid cancer were developed by the American Thyroid Association, European Association of Nuclear Medicine, Society of Nuclear Medicine and Molecular Imaging, and European Thyroid Association. In this review, we present our clinical practice recommendations with regard to implementing these principles in the diagnosis, treatment, and long-term follow-up of patients with DTC. Methods A multidisciplinary panel of five thyroid cancer experts addressed the implementation of the Martinique Principles in routine clinical practice based on clinical experience and evidence from the literature. Results We provide a suggested approach for the assessment and diagnosis of DTC in routine clinical practice, including the use of neck ultrasound, measurement of serum thyroid-stimulating hormone and calcitonin, fine-needle aspiration, cytology, and molecular imaging. Recommendations for the use of surgery (lobectomy vs. total thyroidectomy) and postoperative RaIT are also provided. Long-term follow-up with neck ultrasound and measurement of serum anti-thyroglobulin antibody and basal/stimulated thyroglobulin is standard, with 123/131I radioiodine diagnostic whole-body scans and 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography suggested in selected patients. Management of metastatic DTC should involve a multidisciplinary team. Conclusions In routine clinical practice, the Martinique Principles should be implemented in order to optimize clinical management/outcomes of patients with DTC.

Esthetic Restorative Options for Pulpotomized Primary Molars: A Review of Literature

2011 ◽  
Vol 36 (2) ◽  
pp. 123-126 ◽  
Author(s):  
Marcio Guelmann ◽  
Joseph Shapira ◽  
Daniela Silva ◽  
Anna Fuks
Keyword(s):  
Hybrid Composites ◽  
Primary Molars ◽  
Glass Ionomer ◽  
Limited Information ◽  
Resin Modified Glass Ionomer ◽  
Alternative Materials ◽  
Long Term Follow Up ◽  
Better Than

Objective: The goal of this manuscript was to review the existing literature in regards to esthetic options to restore pulpotomized primary molars. Study design: A pubmed literature search has been performed and all relevant studies were assessed. Results: Two laboratory, 3 restrospective and 4 prospective clinical studies were found, reviewed and analyzed. Conclusions: Based on the limited information available, we concluded that tooth colored and bonded restorations showed promising results as alternative materials to replace stainless steel crowns after pulpotomies in primary molars. Hybrid composites tend to perform better than compomers. Resin modified glass ionomer cements demonstrated excellent marginal seal and retention. More long-term follow up studies are necessary until more definitive recommendations can be made.

Abstract 730: Annual hazard rate of recurrence in Middle-Eastern papillary thyroid cancer over a long-term follow-up

2021 ◽  
Author(s):  
Abdul K. Siraj ◽  
Sandeep K. Parvathareddy ◽  
Zeeshan Qadri ◽  
Saud Azam ◽  
Felisa De Vera ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Hazard Rate ◽  
Middle Eastern ◽  
Papillary Thyroid ◽  
Long Term Follow Up

scholarly journals ABCD3-I and ABCD2 Scores in a TIA Population with Low Stroke Risk

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Fredrik Ildstad ◽  
Hanne Ellekjær ◽  
Torgeir Wethal ◽  
Stian Lydersen ◽  
Hild Fjærtoft ◽  
...  
Keyword(s):  
Stroke Risk ◽  
Risk Scores ◽  
Short Term ◽  
Clinical Trial Registration ◽  
Long Term Follow Up ◽  
Risk Patients ◽  
Abcd2 Score ◽  
Short Term Prediction

Objectives. We aimed to evaluate the ABCD3-I score and compare it with the ABCD2 score in short- (1 week) and long-term (3 months; 1 year) stroke risk prediction in our post-TIA stroke risk study, MIDNOR TIA. Materials and Methods. We performed a prospective, multicenter study in Central Norway from 2012 to 2015, enrolling 577 patients with TIA. In a subset of patients with complete data for both scores ( n = 305 ), we calculated the AUC statistics of the ABCD3-I score and compared this with the ABCD2 score. A telephone follow-up and registry data were used for assessing stroke occurrence. Results. Within 1 week, 3 months, and 1 year, 1.0% ( n = 3 ), 3.3% ( n = 10 ), and 5.2% ( n = 16 ) experienced a stroke, respectively. The AUCs for the ABCD3-I score were 0.72 (95% CI, 0.54 to 0.89) at 1 week, 0.66 (95% CI, 0.53 to 0.80) at 3 months, and 0.68 (0.95% CI, 0.56 to 0.79) at 1 year. The corresponding AUCs for the ABCD2 score were 0.55 (95% CI, 0.24 to 0.86), 0.55 (95% CI, 0.42 to 0.68), and 0.63 (95% CI, 0.50 to 0.76). Conclusions. The ABCD3-I score had limited value in a short-term prediction of subsequent stroke after TIA and did not reliably discriminate between low- and high-risk patients in a long-term follow-up. The ABCD2 score did not predict subsequent stroke accurately at any time point. Since there is a generally lower stroke risk after TIA during the last years, the benefit of these clinical risk scores and their role in TIA management seems limited. Clinical Trial Registration. This trial is registered with NCT02038725 (retrospectively registered, January 16, 2014).

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